Missy Clyne Diaz  |  October 22, 2014

Category: Consumer News

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Unum disabiliy insurance problems

A Florida woman has filed a lawsuit against Unum Life Insurance Company of America, accusing the disability insurance giant of unjustly stopping her disability payments even though she remains disabled.

According to the Unum lawsuit, plaintiff Christy Ezekiel was working at Regions Bank in Bay County, Florida when she became disabled in July 2011 as a result of depression and anxiety stemming from lumbar fusion, chronic neck and back pain and fibromyalgia.

Ezekiel was current on her disability premium and received long-term disability from January 2012 through January 2014, when Unum discontinued payments, according to the Unum lawsuit.

Ezekiel is one of thousands of Americans who have filed claim denial lawsuits against Unum, the largest disability insurance provider in the country. Unum has 40 percent share of the market.

Plaintiffs accuse Unum of bad faith practices such as denying claims and unlawfully discontinuing disability payments in an attempt to boost company profits. Unum allegedly makes decisions based on profits instead of policy.

The company’s allegedly nefarious practices have resulted in a multi-state investigation and a class action lawsuit to research all claims of Unum benefit denials. The company has been reprimanded for its refusal to consider medical opinions of doctors not employed by Unum, something a court found to be illegal.

Unum’s alleged denial tactics include things like changing policies after claims are filed (without the knowledge or consent of policy holders), obtaining opinions from unqualified “experts,” improperly investigating claims, using contract medical examiners to interpret medical records, using third-party medical examiners to deny claims when policyholders did not provide a medical exam, not providing policyholders sufficient time to obtain a medical exam, requiring repeated independent medical examinations, denying a claim without any medical examination and refusing to acknowledge certain disabilities, specifically mental illness, fibromyalgia, and chronic fatigue syndrome.

Unum is also allegedly notorious for maintaining that claims fall under a pre-existing condition as well as acting in bad faith to “wear down” a claimant in the hopes that they will accept a lower settlement.

Unum and its subsidiaries, such as Provident Life, The Paul Revere Life Insurance Company and Colonial Life & Accident Insurance Company, have all been accused of unlawfully refusing to pay valid disability claims in disability insurance lawsuits.

Unum was ordered to pay a urology surgeon with disabling ankle pain $1.5 million for unfairly denying his claim and $36 million to an eye surgeon who could no longer perform surgery after being diagnosed with Parkinson’s disease. Unum had denied the doctor’s disability claim.

In general, Unum lawsuits are filed individually by each plaintiff and are not class actions.

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